Investigational Drug Effective Against Resistant Hypertension
Lorundrostat, the first in a new class of medications known as aldosterone synthase inhibitors, may rein in resistant hypertension, blood pressure that remains high despite concurrent use of three classes of blood pressure medications. In a recent study, researchers from Cleveland Clinic and other centers assigned 285 people (mean age 60) with resistant hypertension to a standardized antihypertensive regimen of indapamide (or hydrochlorothiazide), olmesartan and amlodipine for three weeks. All of the participants underwent 24-hour blood pressure monitoring, and for those who remained hypertensive, the investigators added 50 milligrams (mg) a day of lorundrostat, 50 mg of the drug increased (titrated) to 100 mg daily or a placebo. After 12 weeks, systolic blood pressure decreased by an average of 15.4 millimeters of mercury (mmHg) in the lorundrostat 50 mg group and 13.9 mmHg in the lorundrostat titrated treatment group, compared with a 7.4 mmHg reduction in the placebo group, the study found. Lorundrostat was generally well tolerated, but rates of adverse events were higher among the titrated group, suggesting no benefit to titrating the dose of the drug (American College of Cardiology Scientific Session, March 2025).
